About

Edward Andrew Ochroch, M.D., is a Professor of Anesthesiology and Critical Care at the Hospital of the University of Pennsylvania. He serves as the Chair of the Departmental Committee on Appointments and Promotions at UPHS. His educational background includes a BA from Swarthmore College (1987), an M.D. from the University of Pennsylvania (1992), and an MSCE in Epidemiology from the University of Pennsylvania's Center for Epidemiology and Biostatistics (2005). His research expertise focuses on perioperative clinical trials and thoracic and vascular anesthesia. Dr. Ochroch has contributed to the field through various publications and is involved in clinical and research activities related to anesthesiology and critical care.

Research topics

• Medicine
• Anesthesia
• Surgery
• Internal medicine
• Intensive care medicine

Selected publications

• Hormonal basis of sex differences in anesthetic sensitivity

  Proceedings of the National Academy of Sciences · 2024-01-08 · 56 citations

  articleOpen access

  General anesthesia-a pharmacologically induced reversible state of unconsciousness-enables millions of life-saving procedures. Anesthetics induce unconsciousness in part by impinging upon sexually dimorphic and hormonally sensitive hypothalamic circuits regulating sleep and wakefulness. Thus, we hypothesized that anesthetic sensitivity should be sex-dependent and modulated by sex hormones. Using distinct behavioral measures, we show that at identical brain anesthetic concentrations, female mice are more resistant to volatile anesthetics than males. Anesthetic sensitivity is bidirectionally modulated by testosterone. Castration increases anesthetic resistance. Conversely, testosterone administration acutely increases anesthetic sensitivity. Conversion of testosterone to estradiol by aromatase is partially responsible for this effect. In contrast, oophorectomy has no effect. To identify the neuronal circuits underlying sex differences, we performed whole brain c-Fos activity mapping under anesthesia in male and female mice. Consistent with a key role of the hypothalamus, we found fewer active neurons in the ventral hypothalamic sleep-promoting regions in females than in males. In humans, we demonstrate that females regain consciousness and recover cognition faster than males after identical anesthetic exposures. Remarkably, while behavioral and neurocognitive measures in mice and humans point to increased anesthetic resistance in females, cortical activity fails to show sex differences under anesthesia in either species. Cumulatively, we demonstrate that sex differences in anesthetic sensitivity are evolutionarily conserved and not reflected in conventional electroencephalographic-based measures of anesthetic depth. This covert resistance to anesthesia may explain the higher incidence of unintended awareness under general anesthesia in females.

  PublisherDOI

• The posterior dominant rhythm: an electroencephalographic biomarker for cognitive recovery after general anaesthesia

  British Journal of Anaesthesia · 2022-02-16 · 17 citations

  articleOpen access
  PublisherOA PDFDOI

• Recovery of consciousness and cognition after general anesthesia in humans

  eLife · 2021-05-10 · 106 citations

  articleOpen access

  Understanding how the brain recovers from unconsciousness can inform neurobiological theories of consciousness and guide clinical investigation. To address this question, we conducted a multicenter study of 60 healthy humans, half of whom received general anesthesia for 3 hr and half of whom served as awake controls. We administered a battery of neurocognitive tests and recorded electroencephalography to assess cortical dynamics. We hypothesized that recovery of consciousness and cognition is an extended process, with differential recovery of cognitive functions that would commence with return of responsiveness and end with return of executive function, mediated by prefrontal cortex. We found that, just prior to the recovery of consciousness, frontal-parietal dynamics returned to baseline. Consistent with our hypothesis, cognitive reconstitution after anesthesia evolved over time. Contrary to our hypothesis, executive function returned first. Early engagement of prefrontal cortex in recovery of consciousness and cognition is consistent with global neuronal workspace theory.

  PublisherDOI

• Author response: Recovery of consciousness and cognition after general anesthesia in humans

  2021-02-15

  peer-reviewOpen access

  Cognitive reconstitution after pharmacologic unconsciousness is an extended process, executive function is more robust than expected, and the healthy human brain is resilient to the effects of deep general anesthesia.

  PublisherDOI

• Recovery of Consciousness and Cognition after General Anesthesia in Humans

  bioRxiv (Cold Spring Harbor Laboratory) · 2020-05-30 · 12 citations

  preprintOpen access

  Abstract Understanding how consciousness and cognitive function return after a major perturbation is important clinically and neurobiologically. To address this question, we conducted a three-center study of 30 healthy humans receiving general anesthesia at clinically relevant doses for three hours. We administered a pre- and post-anesthetic battery of neurocognitive tests, recorded continuous electroencephalography to assess cortical dynamics, and monitored sleep-wake activity before and following anesthetic exposure. We hypothesized that cognitive reconstitution would be a process that evolved over time in the following sequence: attention, complex scanning and tracking, working memory, and executive function. Contrary to our hypothesis, executive function returned first and electroencephalographic analyses revealed that frontal cortical dynamics recovered faster than posterior cortical dynamics. Furthermore, actigraphy indicated normal sleep-wake patterns in the post-anesthetic period. These recovery patterns of higher cognitive function and arousal states suggest that the healthy human brain is resilient to the effects of deep general anesthesia.

  PublisherOA PDFDOI

• The Year in Vascular Anesthesia: Selected Highlights From 2019

  Journal of Cardiothoracic and Vascular Anesthesia · 2020-07-15 · 1 citations

  articleSenior author
  PublisherDOI

• Management of the difficult airway in the <scp>COVID</scp>‐19 pandemic: Illustrative complex head and neck cancer scenario

  Head & Neck · 2020-04-16 · 15 citations

  articleOpen access

  BACKGROUND: This case highlights challenges in the assessment and management of the "difficult airway" patient in the SARS-CoV-2 (COVID-19) pandemic era. METHODS: A 60-year-old male with history of recent transoral robotic surgery resection, free flap reconstruction, and tracheostomy for p16+ squamous cell carcinoma presented with stridor and dyspnea 1 month after decannulation. Careful planning by a multidisciplinary team allowed for appropriate staffing and personal protective equipment, preparations for emergency airway management, evaluation via nasopharyngolaryngoscopy, and COVID testing. The patient was found to be COVID negative and underwent imaging which revealed new pulmonary nodules and a tracheal lesion. RESULTS: The patient was safely transorally intubated in the operating room. The tracheal lesion was removed endoscopically and tracheostomy was avoided. CONCLUSIONS: This case highlights the importance of careful and collaborative decision making for the management of head and neck cancer and other "difficult airway" patients during the COVID-19 epidemic.

  PublisherOA PDFDOI

• Risk of Persistent Opioid Use following Major Surgery in Matched Samples of Patients with and without Cancer

  Cancer Epidemiology Biomarkers & Prevention · 2020-08-28 · 12 citations

  articleOpen access

  Abstract Background: The opioid crisis has reached epidemic proportions, yet risk of persistent opioid use following curative intent surgery for cancer and factors influencing this risk are not well understood. Methods: We used electronic health record data from 3,901 adult patients who received a prescription for an opioid analgesic related to hysterectomy or large bowel surgery from January 1, 2013, through June 30, 2018. Patients with and without a cancer diagnosis were matched on the basis of demographic, clinical, and procedural variables and compared for persistent opioid use. Results: Cancer diagnosis was associated with greater risk for persistent opioid use after hysterectomy [18.9% vs. 9.6%; adjusted OR (aOR), 2.26; 95% confidence interval (CI), 1.38–3.69; P = 0.001], but not after large bowel surgery (28.3% vs. 24.1%; aOR 1.25; 95% CI, 0.97–1.59; P = 0.09). In the cancer hysterectomy cohort, persistent opioid use was associated with cancer stage (increased rates among those with stage III cancer compared with stage I) and use of neoadjuvant or adjuvant chemotherapy; however, these factors were not associated with persistent opioid use in the large bowel cohort. Conclusions: Patients with cancer may have an increased risk of persistent opioid use following hysterectomy. Impact: Risks and benefits of opioid analgesia for surgical pain among patients with cancer undergoing hysterectomy should be carefully considered.

  PublisherOA PDFDOI

• The Year in Vascular Anesthesia: Selected Highlights From 2018

  Journal of Cardiothoracic and Vascular Anesthesia · 2019-05-01

  reviewSenior author
  PublisherDOI

• Vascular Surgery

  Elsevier eBooks · 2019-01-01 · 2 citations

  book-chapterSenior author
  PublisherDOI

Recent grants

• NIH Grant K23HD040914

  NIH · $650k · 2007

Frequent coauthors

• Allan Gottschalk

  Johns Hopkins University

  14 shared

• John Augoustides

  University of Pennsylvania

  14 shared

• Elizabeth Valentine

  Lahey Hospital and Medical Center

  12 shared

• Richard M. Levitan

  Regional Health

  10 shared

• Joanne Guay

  Université du Québec en Abitibi-Témiscamingue

  9 shared

• Nabil Elkassabany

  University of Virginia Health System

  7 shared

• Judd E. Hollander

  Thomas Jefferson University

  7 shared

• David M. Eckmann

  The Ohio State University

  7 shared

Labs

• Edward Andrew Ochroch LabPI